Overactive Bladder

What is an overactive bladder?

Overactive bladder represents a collection of symptoms that include:

  • urinary urgency — failure to be able to postpone the need to urinate
  • frequency of urination — the need to urinate at least eight times per day
  • urge incontinence — leakage of urine when one gets the urge to urinate
  • nocturia — the need to get up and urinate at least two times per night

What causes an overactive bladder?

Urine leakage and bladder control problems can have many possible causes. These include:

  • Weak pelvic muscles — muscles that have become stretched and weak due to pregnancy and childbirth, which in turn have let the bladder sag out of position and have stretched the opening of the urethra causing urine leakage.
  • Nerve damage — sending signals to the brain and bladder to empty at the wrong time. Diseases that can cause nerve damage include diabetes, Parkinson’s, multiple sclerosis, and stroke. Trauma that can cause nerve damage includes pelvic or back surgery,
    herniated disc, and radiation.
  • Medications, alcohol, caffeine — these products can dull the nerves, affecting the signal to the brain, resulting in bladder overflow. Diuretics and caffeine can cause rapid bladder filling and may cause bladder leakage.
  • Infection — a urinary tract infection can irritate bladder nerves and cause the bladder to squeeze without warning.
  • Excess weight — being overweight puts pressure on the bladder and contributes to urge incontinence.

How is overactive bladder treated?

There are a number of different methods to treat bladder control problems. In the particular case of overactive
bladder, your doctor has determined that a number of behavioral modification techniques are best suited to
address the issues causing your bladder problems.

Bladder overactivity is a very common condition. It is very treatable, but requires assistance from both the physician and the patient. Carefully read and follow the information on the attached pages. If you have any questions, do not hesitate to ask your physician or other health care professional.

Behavioral Modification Techniques to Help Your Overactive Bladder

Monitor your diet

Eliminate or decrease foods or beverages that may worsen bladder symptoms. These include:

  • Tea
  • Coffee
  • Alcohol
  • Chocolate
  • Caffeinated soft drinks (even decaffeinated coffee and tea contain some caffeine)
  • Citrus juices and fruits
  • Tomatoes and tomato-based products
  • Spicy and acidic foods and drinks
  • Foods and drinks containing artificial sweeteners

Maintain bowel regularity

Constipation can place added pressure on the bladder and have a negative effect on bladder function. By keeping healthy bowel habits, you may be able to avoid constipation and help to lessen bladder symptoms. The following are some suggestions for maintaining bowel regularity:

  • Increase fiber intake by eating foods such as beans, pasta, oatmeal, bran cereal, whole wheat bread, and fresh fruits and vegetables.
  • Every morning take 2 tablespoons of this mixture: 1 cup apple sauce, 1 cup unprocessed wheat bran, and ¾ cup prune juice.
  • Exercise to maintain regular bowel movements.

If you continue to have bowel problems, see your doctor.

Maintain a healthy weight

Being overweight can add pressure on your bladder, which may contribute to bladder control problems. If you are overweight, weight loss can reduce pressure on your bladder.

Stop smoking

Cigarette smoking is irritating to the bladder muscle. Repeated coughing spasms due to smoker’s cough can cause urine leakage.

Drink plenty of nonirritating fluids

People with bladder symptoms often drink fewer liquids so they don’t have to urinate as often. You should
regularly drink about 3 to 4 glasses of liquids per day. Try to spread them out as evenly as possible
throughout the day. Drinking fewer fluids causes you to produce more concentrated (dark yellow, strong-smelling)
urine. Highly concentrated urine is irritating to the bladder and may actually cause more frequent urination. Limit your intake starting 2 or 3 hours before going to bed.

Decrease or eliminate beverages that may worsen bladder symptoms. These include tea, coffee, alcohol, caffeinated soft drinks, citrus juices, and drinks that contain artificial sweeteners.

Consider bladder retraining

When you have overactive bladder, over time your bladder muscles become conditioned to react in a certain way. By retraining these muscles, you can hold urine better. Bladder retraining involves working with a healthcare professional to learn how to resist or inhibit the feeling of urgency; postpone voiding; and urinate according to a timetable (rather than in response to a feeling of urgency).
Bladder retraining involves learning to:

  • Gradually increase the time between bathroom visits. If you normally go every hour, try to increase it to 1 hour and 15 minutes between visits.
  • When you can maintain your new schedule without accident for 1 to 2 weeks, try increasing the time between bathroom visits by an additional 15 minutes
    until you reach an interval you feel comfortable with. The goal is to reach an interval of 2 to 4 hours between bathroom visits.
  • Stick to the schedule as much as possible, whether you have to go or not.

Controlling the Urge

The key to bladder retraining is developing the ability to control urinary urges. When you experience a sudden urge, the following strategies may help:

  • Stop what you are doing and stay put. Sit down when possible, or stand quietly. Remain very still. When you are still, it is easier to control your urge.
     
  • Squeeze your pelvic floor muscles quickly several times. Do not relax fully in between.
  • Relax the rest of your body. Take a few deep breaths to help you relax and let go of your tension.
  • Concentrate on suppressing the urge feeling.
  • Wait until the urge subsides
  • Walk to the bathroom at a normal pace. Do not rush. Continue squeezing your pelvic floor muscles quickly while you walk.

Be patient. An entire bladder retraining program usually takes at least 6 to 8 weeks to produce results.

Talk to your doctor about the best way to manage the symptoms of overactive bladder. He or she may recommend a
combination of overactive bladder medication and bladder retraining to help you achieve the best outcome.

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